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Waste Tire Survey & Inspection Report SURVEY REQUIRED <br /> '� Ir State of Cellfomin <br /> CIM16183(New 04/04( Comments Form <br /> Callfomla Integrated Waste Managernenl Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection <br /> TPID- p—(J J _ <br /> Site Suffix: ' / 3 � 7 J / 1 Number: I 1 (^7 � / v / <br /> Inspection Number on the associated Survey form(Page f) <br /> Comments <br /> Js?�``'fD�✓'T " _ �dq al A10 <br /> P � <br /> ■ IElxlmlMipl�lEl 1112131 42408 <br /> White Copy.CIWMB Yellow Copy:operator Pink Copy LEA <br />